defining the cause of death in hospitalised patients with acute kidney injury死亡的定义原因住院患者急性肾损伤.pdfVIP

Defining the Cause of Death in Hospitalised Patients with Acute Kidney Injury 1 1 1,2 3 3 Nicholas M. Selby *, Nitin V. Kolhe , Christopher W. McIntyre , John Monaghan , Nigel Lawson , 4 1 1 David Elliott , Rebecca Packington , Richard J. Fluck 1 Department of Renal Medicine, Royal Derby Hospital, Derby, United Kingdom, 2 School of Graduate Entry Medicine and Health, University of Nottingham, Nottingham, United Kingdom, 3 Department of Chemical Pathology, Royal Derby Hospital, Derby, United Kingdom, 4 Department of Informatics, Royal Derby Hospital, Derby, United Kingdom Abstract Background: The high mortality rates that follow the onset of acute kidney injury (AKI) are well recognised. However, the mode of death in patients with AKI remains relatively under-studied, particularly in general hospitalised populations who represent the majority of those affected. We sought to describe the primary cause of death in a large group of prospectively identified patients with AKI. Methods: All patients sustaining AKI at our centre between 1st October 2010 and 31st October 2011 were identified by real- time, hospital-wide, electronic AKI reporting based on the Acute Kidney Injury Network (AKIN) diagnostic criteria. Using this system we are able to generate a prospective database of all AKI cases that includes demographic, outcome and hospital coding data. For those patients that died during hospital admission, cause of death was derived from the Medical Certificate of Cause of Death. Results: During the study period there were 3,930 patients who sustained AKI; 62.0% had AKI stage 1, 20.6% had stage 2 and 17.4% stage 3. In-hospital mortality r